Background: Fibroid is the most common pelvic tumor in women, with a prevalence of 30%–50% in the general population. Cystic degeneration occurs in 4 % and is mainly a pseudocyst derived from liquefaction of hyaline changes. Case: A 22-year-old nulligravida was seen with the largest cystic degenerated leiomyoma ever reported in the literature. The cyst measured 67×45×39 cm, was multiloculated, and contained 11 L of serous fluid. Results: Excellent hemostasis was obtained and estimated blood loss was 1100 mL. No intraoperative blood transfusion was given, but immediately after the operation the patient was transfused with 2 U of packed red blood cells. Her fertility was preserved. The postoperative course was unremarkable, and the patient was discharged on the fourth postoperative day. She was subsequently seen in the gynecologic clinic for follow-up three times and no significant abnormalities were found. Conclusions: The patient had a fertility-preserving surgery with an uncomplicated postoperative course. (J GYNECOL SURG 27:299)
Get full access to this article
View all access options for this article.
References
1.
WestPC. Uterine fibroids and menorrhagia. LuesleyDM, BakerPN. Obstetrics and Gynecology: An Evidence-Based Text for MRCOG, 1. London: Arnold, 2004; 526.
Day BairdD, DunsonDB, HillMC, CousinsD, SchectmanJM. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. Am J Obstet Gynecol, 2003; 188:100.
4.
WuJM, WechterME, GallerEJ, NguyenTV, ViscoAG. Hysterectomy rates in the United States 2003. Obstet Gynecol, 2007; 110:1091.
5.
ChenCR, BuckGM, CoureyNG, PerezKM, Wactawski-WendeJ. Risk factors for uterine fibroids among women undergoing tubal sterilization. Am J Epidemiol, 2001; 153:20.
6.
OkoloS. Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol, 2008; 22:571.
7.
MarshallLM, SpiegelmanD, BarbieriRL, GoldmanMBet al.Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol, 1997; 90:967.
PraysonRA, HartWR. Pathologic consideration of uterine smooth muscle tumors. Obstet Gynecol Clin North Am, 1995; 22:637.
10.
ParulekarSV. Cystic degeneration in an adenomyoma (a case report)J Postgrad Med, 1990; 36:46.
11.
ScholzP, KuhntC. Uterus myomatousus with large cystic multilocular pseudocystic degeneration: On the differential diagnosis of uterus cyst. Zentralhl Gynakol, 1991; 113:157.
12.
PomiliG, FratiniD, ServidioF, Alunni CarrozzaL, AffrontiG, GilardiG. Giant pedunculated clustered uterine firbomyoma in hyaline and cystic degeneration: Limitation of clinical and instrumental diagnosis. Minerva Ginecol, 1996; 48:49.
13.
YarwoodRL, ArroyoE. Cystic degeneration of uterine leiomyoma masquerading as a postmenopausal ovarian cyst: A case report. J Reprod Med, 1999; 44:649.
14.
VerrasM, AntoniouS, SamaraCH, FrakalaS, Angelidou-ManikaZ, PaissiosP. Intraperitoneal hemorrhage secondary to perforation of uterine fibroid after cystic degeneration: Unusual CT findings resembling malignant pelvic tumor. Case report. Eur J Gynaecol Oncol, 2002; 23:565.
15.
KulshresthaR, LakheyM, RaniS. Massive cystic degeneration of a uterine leiomyoma presenting as an ovarian cyst: A case report. Indian J Pathol Microbiol, 2003; 46:86.
16.
LowSC, ChongCL. A case of cystic leiomyoma mimicking an ovarian malignancy. Ann Acad Med Singapore, 2004; 33:371.
17.
CordeiroA, AmbrosioP, MartinsP, DamasoJ, MonizL. Uterus with hepatic adhesion. A case report. Internet J Gynecol Obstet, 2005; 5:1.
18.
GrapsaD, SmymiotisV, HasiakosD, Kontogianni-KatsarouK, Kondi-PafitiA. A giant uterine leiomyoma simulating an ovarian mass in a 16 year old girl: A case report and review of the literature. Eur J Gynaecol Oncol, 2006; 27:294–6.
19.
YamashiroT, GiboM, UtsunomiyaT, MurayamaS. Huge uterine leiomyoma with adenomyotic cysts mimicking uterine sarcoma on MR imaging. Radiat Med, 2007; 25:127.
